Risk Management Series: Incremental Seismic Rehabilitation of Hospital Buildings (FEMA 396 / December 2003)

This manual is intended to assist healthcare organization personnel responsible for the funding and operation of existing hospital facilities across the United States. This publication and its companion documents are the products of a Federal Emergency Management Agency (FEMA) project to develop the concept of incremental seismic rehabilitation—that is, building modifications that reduce seismic risk by improving seismic performance and that are implemented over an extended period, often in conjunction with other repair, maintenance, or capital improvement activities. The manual was developed after the project team analyzed the management practices of healthcare organizations located in various seismic zones in different parts of the United States. It focuses on the identified concerns and decision making practices of hospital managers and administrators. Earthquakes are a serious threat to hospital safety and pose a significant potential liability to hospital administrators and healthcare organizations. Hospital buildings in 39 states are vulnerable to earthquake damage. Unsafe existing buildings expose healthcare organizations to the following risks: Death and injury of patients, doctors, nurses, and Staff; Damage to or collapse of buildings; Damage to and loss of furnishings, equipment, and other building contents; Disruption of patient care and other hospital operations; Loss of an indispensable community resource The greatest earthquake risk is associated with existing hospital buildings that were designed and constructed before the use of modern building codes. For many parts of the United States, this includes buildings built as recently as the early 1990s. Although vulnerable hospital buildings need to be replaced with safe, new construction or rehabilitated to correct deficiencies, for some healthcare organizations new construction is limited, at times severely, by budgetary constraints, and seismic rehabilitation is expensive and disruptive. However, incremental seismic rehabilitation, an innovative approach that phases in a series of discrete rehabilitation actions over a period of several years, is an effective, affordable, and non-disruptive strategy for responsible mitigation action. It can be efficiently integrated into ongoing facility maintenance and capital improvement operations to minimize cost and disruption. The strategy of incremental seismic rehabilitation makes it possible to get started now on improving earthquake safety in your healthcare organization. This manual provides healthcare organizations with the information necessary to assess the seismic vulnerability of their buildings and to implement a program of incremental seismic rehabilitation for those buildings.